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Organization

ORCHARD MAPLE FAMILY DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM HENRY WOODRUFF JR. D.D.S (PRESIDENT)
(248) 851-2876
Entity
Organization

Contact information

Practice address
6280 ORCHARD LAKE RD, WEST BLOOMFIELD, MI 48322-2321
(248) 851-2876
(248) 851-1669
Mailing address
6280 ORCHARD LAKE RD, WEST BLOOMFIELD, MI 48322-2321
(248) 851-2876
(248) 851-1669

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11170
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3482290
MI
Enumeration date
05/03/2011
Last updated
05/03/2011
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